Parish Nurses: Integrating Heath and Family
Tuesday April 1, 2003
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This often-quoted Biblical verse speaks so beautifully of the timeliness of our universal life experiences. In our profession, our roles also evolve and grow - like the seasons - to meet the needs presented by our society and our healthcare practices. And out of these needs nursing specialties develop. Parish nursing, designated as a specialty by the American Nurses Association in 1998, is one of those specialties.
The role of parish nursing is still being shaped, and part of that evolution includes a shift toward using the term "congregational nursing," although parish nursing continues to be the traditional term. "The role name used is most reflective of the tradition of the church in which the nurse is serving," explains Nancy Yuill, RN, PhD, dean of the Houston Baptist University College of Nursing. The school offers a congregational care program as an option for a graduate degree, either as a standalone degree or in combination with the family nurse practitioner program.
Caring for people within a faith community is not a new concept. According to the International Parish Nurse Resource Center (IPNRC): "The parish nurse role reclaims the historic roots of health and healing found in many religious traditions. Parish nurses are continuing the early work of monks, nuns, deacons, and deaconesses."1
Dr. Granger Westberg, a Lutheran minister, is credited with the contemporary view of parish nursing. Westberg, who served as a hospital chaplain for a large Chicago hospital in the 1980s, believed the spiritual dimension of healing was disregarded in traditional healthcare, and in his view, nurses "served as interpreter...they were the glue keeping body and soul together."2
The role of the parish nurse is multifaceted and includes serving as health educator, health counselor, trainer, and referral source. The parish nurse works with the church health cabinet to plan group activities such as support groups, education classes, and health screenings. "Nurses are in a unique position to serve in a spiritual health type of ministry," Yuill says. "In addition to the high degree of public trust nurses hold, nurses have a holistic approach to health, and spirituality is a natural component of that holistic approach."
Designing a Custom Fit
Although all parish nurses have the common goal of integrating faith and health, no two congregational ministries are the same. Each ministry will be determined by the demographics and needs of the individual congregation. For example, parish nurses may work part- or full-time, in paid positions, or serve as volunteers. Some churches form their own ministries and hire nurses independently while others partner with health systems or government agencies.
"There's a definite advantage in partnering with a healthcare system because of the resources that are available," says Debbie Seider, RN, MSN, congregational nursing coordinator at the Methodist Hospitals of Dallas. The Methodist Hospitals partner with 21 area churches.
Seider works with nurses and health ministries in assessing and designing a plan to meet identified needs. "Generally, we assess a congregation's needs through a survey that asks a variety of questions," Seider says. "The pastor or the nurse may also notice patterns - an increase in members diagnosed with cancer or perhaps a significant number of deaths within the last month." Older church members may want information about diabetes while young parents may be interested in parenting and childcare issues.
To ensure a successful health ministry, the nurse, clergy, and church leaders must all have a clear expectation of how the nurse will function. "The church leadership needs to know that the nurse will not be doing hands-on nursing while the nurse must be clear about what he or she will do within their ministry," Seider explains. As nurses serve as volunteers in this model, their time commitment may vary from eight hours a month to full-time.
A Day in the Life
Although the versatility and flexibility found in parish nursing is a definite plus, it can take some adjustment. "There's no set routine like the hospital, with tasks like receiving report and giving medication. This challenges me to use my time in the most effective way," says Kay McLellan, RN, NSN, MA, a Wesley nurse employed by the Methodist Healthcare Ministries of South Texas. The term "Wesley" is used within the Methodist Ministries program, and unlike the traditional parish nurse model, Wesley nurses occasionally do some hands-on nursing as part of their ministries.
As the parish nurse at Parker Lane United Methodist church, McLellan works 40 hours per week and serves a congregation of 250 members. Part of her mission includes involvement in the surrounding community, so she does health teaching and screenings in several of the Ministries' programs. One of these programs, Avante, serves young Hispanic families, and McLellan says with a chuckle, "I am feverishly learning Spanish."
A typical day keeps McLellan jumping. "After checking in with the pastor, I review my e-mail to see if there's any work to coordinate with our San Antonio headquarters," she says. "After setting up and facilitating our senior citizen exercise class, I go to visit some of the clinics where I send referrals. Then, there's a lunch meeting to plan for an Alzheimer's support group. In the afternoon, I visit several shut-ins who require some medication assistance, so I set up their pills for the week.
"After a home visit to change a dressing for one of our church members without insurance, I head to the hospital to visit several congregation members. We pray together. This month we're teaching an evening workshop for families, so after dinner, I return again to the church."
Is Parish Nursing for You?
For McLellan, parish nursing is a career choice and a calling. During her nursing career, she has worked in many different specialties, but says she couldn't seem to find the right niche. "I questioned why, but now I realize the Lord was preparing me for this work," she says. "The knowledge I gained by working in so many different areas of nursing prepared me for this calling."
Seider says flexibility and creativity, combined with a broad knowledge of nursing, is important for parish nurses. "[But] to be truly effective, you must be mature in your faith walk, active in your church, and vitally involved in the church membership," she adds. "If you enter into sacred, intimate moments with people, it must come from your
faith - the stewardship of your gifts."
According to Rev. Deborah Patterson, executive director of IPNRC, 7,000 nurses have completed the curriculum for parish nursing that the IPNRC coordinates. "The role of congregational care will continue to evolve to meet changing needs as the population changes," Yuill says. "And churches offer a natural setting for assisting families and providing respite for family members giving the care."
As the specialty continues to evolve, parish nurses are studying outcomes. They're seeing positive, concrete results within their ministries, evidenced by the increased knowledge of healthcare and use of preventive care taking place within their health ministries.
If you would like to work in an independent nursing model, one without reimbursement or time boundaries, one in which you can pray with your patients, you may want to consider parish nursing. "Parish nursing offers an opportunity to have long relationships with your patients," McLellan says. "And being able to pray with them is a wonderful feeling."
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